AIBU to think that this is not an appropriate letter to send to pregnant mums?

[Magicmonster]

I am 33weeks pregnant. I have received a letter from an organisation that appears to be affiliated to my local hospital inviting me to participate in a study for women 'who consider that they have put on too much weight during pregnancy'. The study seems to involve participation in a number of weight management projects from 6 weeks post pregnancy including following a slimming world programme.

Having carried out some research online it appears that women are invited to participate in this study if their bmi was over 25 at the time of their booking appointment or they are considered to have put on too much weight during pregnancy.

My bmi at booking appointmnet was 24 and I have put on 11kg during the pregnancy.

But leaving aside the issue of whether I need to lose weight (which is not what this thread is intended to be about), my view is that sending an unsolicited letter like this to women who are heavily pregnant is not the best way to go about supporting women?

I personally don't think that women in the third trimester or who have very recently had a baby should be focusing on weight loss, unless of course their weight is a real problem, in which case I believe that a doctor or midwife should sit down and talk to them about this in person in a sensitive manner, rather than recommending them for a weight management programme without further discussion. Especially when pregnancy hormones can make you feel irrationally upset at the best of times!

I would be interested in people's views as I do feel it was an inappropriate letter to send to any pregnant woman out of the blue. For some people it could place unnecessary pressure on them and lead them to feel like failures at a time when (barring a major weight problem) weight loss should not be high on their agendas. But maybe I am just being too sensitive because of those pregnancy hormones!!

It's really difficult to conduct research through NHS channels (and very rightly so). You have to meet a number of very stringent standards, and go through an ethical approval procedure that can take six months to complete. However, if this has caused you distress it would be worth contacting the researcher to let them know so that they can adjust their recruitment strategy in future studies if necessary.

But OP had a BMI index in the healthy range before the pregnancy, and there's no reason yet to assume that she won't go back to it after pregnancy.
If 25 is the cut off point for non-pregnant people, the cut off point for pregnant people must be higher.

pick I thought the op had implied that it was sent out to people statistically overweight at initial booking in assessment, or who's weight gain would fall into the too rapid category? So targeted to those who fit that criteria.

Somewhat - I disagree that the mw is the person to do the weight chat.

Some mums could feel it is that particular mw picking on them personally instead of general campaign.
. Or they could feel the need is criticising them. Mw is not a weight loss consultant, they have other things to do.
Some mums might lose their trust in mw if they feel mw is overly invested in their weight. Hopefully pg mums are building trust and a bond with the mw service so something as sensitive as essentially being told to lose weight could spoil that relationship/trust.

*mw not need!

People have the right to be overweight/obese.

They have the right to stay overweight/obese and never do anything meaningful about it.

They have the right to ignore all the possible risks to their babies and themselves, during pregnancy/birth.

But what they don't have imo, is the right to complain when the NHS/other agencies are actually trying to do something about it.

Expecting people to take responsibility for their own weight, is clearly not working at all.

I would not have an issue with a letter going out say 3mnths post childbirth asking whether they would be interested in participating in this weight management programme

But then others would say " too much pressure on women to snap back, they should be focusing on their babies, not getting their figures back"

Bottom line is you can decline to participate. Some maybe happy to participate as they may be struggling and excessive weight can lead to problems. If it's not for you fine, but accept it may help others.

I dont get why this is insensitive or how they could have made the approach any differently. You dont have to participate, you might get something out of it.
If you dont want to do it, see your GP or practice nurse and bin the letter.

I've literally spent the morning looking this up. At 38 weeks I think I've been eating too much and have gained more than I should have - which more importantly is causing an issue with my joints.

Thought researching I found that loads of other countries will weigh the mum at every midwife appointment and monitor weight gain - now that can go too far the other way of course, but I wish I had been more aware.

I too probably would have been initially wounded by receiving that letter - but I think would conclude that it's fair enough! I've eaten far too many ice creams the last week!

Ok thanks all. I will accept that I have been over sensitive on this one, as that seems to be the general view.

I do still think that, as some posters have agreed, it would be a good idea to give women a heads up at one of their midwife appointments that the letter is coming their way and why. For example, personally speaking I am left wondering whether the midwives consider my weight gain to be a problem (presumably yes) and if so how much of a problem, as no one has weighed me since my booking appointment or spoken to me about my weight gain since then, I am measuring a week behind (and I was specifically told at booking appointment my bmi was normal). It would take 1-2 mins to explain this at one of the usual appointments so I disagree that it would be a drain on NHS resources.

But on my point re the inappropriate timing of the letter I will accept that IABU.

I'm currently 4.5 months into my mat leave. I put on a whopping 5 stone during pregnancy and I was slightly overweight before even getting pregnant.
I would have loved to get one of these letters as I would gladly take part. I personally didn't rate the support I got from midwives before I gave birth. I wasn't seen as often as I should as our local village surgery could never fit me so ended up going to the hospital instead. Even when asking for appointments 5 weeks in advance. When I asked about my weight they would just shrug it off, saying it's normal. Not interested in giving me advice.
Woman shouldn't be under put under pressure to lose baby weight straight away if they don't want to but I desperately wanted to. So far I've lost 4 stone but would've loved the addition help this could help provide for myself and others in the future.

Artemisia, women are affected by hormones during pg and post birth.

I don't have an issue with it. My BMI was 26 on booking and I'd probably have participated. I actually put on just under a stone and a half when pregnant but maternity leave made me pile on lots more and it's taken a year to start getting back on track.

Obesity is the single biggest issue facing the health service at the moment so I applaud any attempt to try and tackle it. To start with we need to stop skirting around the subject for fear of upsetting people.

Whilst I don't think there is anything wrong with asking you to participate in the study ( you can either be offended or not about the weight thing) my primary concern is why personal medical information is being shared, presumably without your permission.

I got the letter, just chuckled it in the bin and thought no more of it.

I do think that as a society we have become too scared of mentioning weight. I have been a lot heavier and I've been slimmer and life is better slimmer - not just because of looks and clothes but because I feel so much better slimmer and can move more, don't get aching joints, not out of breath at top of stairs etc, cholesterol is better, blood sugar is better - I don't get crazy highs and lows when I'm not eating all the sugary rubbish, I sleep better, my poo doesn't stink the entire bathroom out for half an hour...

Pregnant women get seen once a month at least by the midwife

Uh, no they don't I last saw my midwife at 16 weeks, and will see her next at 28 weeks.

I would participate in this study/feedback whatever, given the info in your OP. I have a BMI of 34 and intend to start SW once the baby is born. I've had a personal trainer for about a year and not lost a smidge, I eat healthy meals, I know it's too much chocolate!

What I think is a bit odd, is that they sent it to people with a BMI over 25 - i.e. people that are overweight already at the beginning of the pregnancy.

So they are looking into both already overweight and those that have become overweight - seems like it's confounding itself doesn't it?

It's always intrigued me in fact - surely there are going to be different health implications if you enter a pregnancy at BMI 18 and end it at 30, vs entering at 30 and ending at 30? So why lump the two groups together?

"There's lot's of reasons why women gain weight in pregnancy"

And the researchers want to look at how frequently they occur, what impact different factors have, what they might mean post natally.

I am amazed that so many people have such a low opinion of medics who design, seek ethical approval for, and then conduct research.

Only those people who fit the criteria can be asked. If you can't ask them, the research won't be done. Getting ethical approval for -anythung to do with pregnant women is a huge set of hurdles.

Receiving a letter inviting participation really isn't something to become upset about. Unless you want to try variations on 'denial' as the best way to advise and support the postnatal community in future.

Maybe that's part of the hypothesis of their study spaghetti?

It sounds to me like the NHS have jumped into bed with a slimming world type programme and are seeking to promote it via a 'study'. It sounds similar to the way in which the Bounty crew made their way onto the maternity wards.

Tempus - hopefully.

I just read an article on cow colostrum and its effects on calves that makes me think we put much more into researching animals than we do humans! When it comes to this kind of thing.

(I know that's not true.. just feels like it to someone on the outside)

"So they are looking into both already overweight and those that have become overweight - seems like it's confounding itself doesn't it?"

On the contrary, this looks like an important aspect to me: are different effects particularly associated with weigh at start of pregnancy, or with certain levels of gain during pregnancy, or with weight immediately post-partum , or any combination of those?

"It's always intrigued me in fact - surely there are going to be different health implications if you enter a pregnancy at BMI 18 and end it at 30, vs entering at 30 and ending at 30? So why lump the two together?"

Because the researchers are capable of number crunching accurately enough to define those groups in order to assess whether there is indeed a difference as you hypothesise.

"But OP had a BMI index in the healthy range before the pregnancy, and there's no reason yet to assume that she won't go back to it after pregnancy"

Good - you need people like that in studies like this. Because it needs to be shown if that is indeed typical (and therefore no intervention needed) or if some other pattern is more common (and thus providing the evidence for advice about weight in future).

Agree with Artemesia I have spent time on an orthopaedic ward recently and was shocked at the number of people that are having to have second surgeries because their hip and knee replacements have failed due to obesity. No-one appears to actually tell people they are fat any more. The reason many people need these ops is because they are flippin massive in the first place. It's not rocket science. We are living in mark one bodies. There has been no upgrade. How can knees and hips designed to carry eight stone seven pound very fit people be expected to carry 18 stone people that do sweet FA all day? The woman in the bed next to me had had her knees and hips done and was now having spinal surgery and she was enormous - sorry but it's true. It's hard to lose weight when sedentary but not impossible. People need to take much more responsibility for themselves but as people do seem to need to be told the obvious, doctors and nurses who are equally as fat quite often need to tell patients the truth.